Abstract
We previously found that a group-based, cognitive behavioral stress management (CBSM) intervention
facilitated psychosocial adaptation after adjuvant therapy in women recently treated for breast cancer by
reducing intrusive thoughts, anxiety, social disruption, and negative affect. The intervention also decreased
physical symptoms (e.g., fatigue, sleep disruption) and stress markers (e.g., serum cortisol levels), as well as,
increased positive affect, benefit finding, and positive states of mind in participants. Such effects held up to one
year after surgery. However, the intervention, as is consistent with the larger body of psycho-oncology
intervention research, focused primarily on white, middle class women, recruited from private practices and
university-based medical centers. The proposed study will address this disparity by adapting our CBSM
intervention for Black breast cancer survivors in South Florida, who are grossly underserved in terms of
psychosocial needs. By partnering with a cancer-focused community organization, the proposed project will
recruit, assess and hold intervention groups in community-based settings. Inclusion will be limited to African
American women (n=120 after attrition), with histologically confirmed breast cancer (Stages I-III) who have
completed curative treatment within six months. Participants will be randomized to either a 10-week CBSM
intervention or an attention-time matched Enhanced Breast Cancer Education control condition. All women
(intervention and control groups) will be monitored for six months after the intervention. Study endpoints
include: (a) intervention acceptability among African American breast cancer survivors; (b) psychosocial
adaptation to disease; (c) physical symptom clusters (e.g., pain, fatigue, sleep disruption); (d) economic
indicators (e.g., return to work, sick days); and, (e) an objective indicator of stress (slope of diurnal salivary
cortisol). The primary goal of the proposed study is to determine whether a successful stress-management
intervention can be effectively implemented in community settings, and to demonstrate that it is efficacious in
facilitating positive adaptation to breast cancer among African American women with breast cancer. Project Narrative
This project will examine the effectiveness of a stress management program for low-income Black women with
breast cancer. This study is in accord with the National Institutes of Health's mission to seek to attenuate
psychosocial difficulties following a breast cancer diagnosis as experienced by Black women in the United
States.